Actinic Keratosis is not a skin cancer but it can be a precursor to skin cancer. For this reason, these skin lesions should never be taken lightly. As soon as you notice one appearing on your skin, you should consult with your doctor so that you can get the proper diagnosis and treatment. If it is an early sign of skin cancer, this can make all the difference in your ability to survive.
The popular name for this condition is solar keratosis and that name tells you almost all you need to know about the condition. They are areas of rough, scaly skin that can develop after prolonged exposure to the UV rays of the sun. It may take years for an actinic keratosis to appear, which is why they are more often seen in older people. Even if you spend time in the sun while you are young and you don’t immediately develop any symptoms, you can still have actinic keratosis later in life.
Because they are directly related to sun exposure, they generally appear on areas of the skin that are more exposed to the sun, including the face, neck, lips, ears, forearms and scalp. Though anyone can develop these growths they tend to be more common among individuals with fair skin and hair and light colored eyes. Individuals with a weakened immune system are also at greater risk of developing actinic keratosis.
What causes precancerous lesions?
As was previously suggested, actinic keratosis is caused by exposure to UV rays, either directly from the sun or from tanning beds. These high intensity light waves can disrupt the normal progression of skin development, causing a variety of abnormalities, the most serious of which is skin cancer.
In healthy skin, older skin cells are forced to the surface and sloughed off over time. When UV rays damage skin cells, the color and texture of the skin can be affected and the ability of the body to slough off the older cells may also be hampered.
What treatment options are there?
Because it is impossible to determine which skin growths will develop into skin cancer, your doctor will likely recommend that any actinic keratosis be removed to prevent the development of skin cancer.
There are several methods for removal of actinic keratosis, ranging from the use of creams and lotions to microdermabrasion. The most effective method will vary from case to case so you need to talk with your doctor to determine which is best for you.
Solar keratoses can be removed by surgery or by freezing with liquid nitrogen. In this procedure, the liquid nitrogen or another extremely cold substance is used to freeze the outer layer of the skin. Once the skin begins to heal, the lesion that has been frozen sloughs off, allowing new skin to grow and take its place.
There are some side effects of cryotherapy, including darkening of the skin, blisters, scarring and infection, but it is generally considered safe and almost painless and can be performed in your doctor’s office in a matter of minutes.
Sometimes doctors are not sure whether the growth is a solar keratosis or an early cancer. When there is doubt, your doctor will likely cut the growth off and send it for microscopic analysis (biopsy). Healing after removal usually takes one to two weeks and leaves a flat white scar.
When there are many keratoses present, a useful treatment is 5-FU (5-fluorouracil) cream. The medication is applied to the involved area twice a day for 4 weeks. The treated area becomes red, raw, and irritated. Healing starts when the 5-FU cream is stopped. A complete course of 5-FU, including healing time, can take up to two months.
New solar keratoses and skin cancers often arise near or at the location where old ones have been treated. This is because the skin cells nearby have just as much damage as the ones already treated. Once a person develops solar keratoses they need to be checked every six to twelve months for new ones.
As far as prevention methods, using a daily sunscreen of SPF 15 of higher will help if the damage isn’t already done. Retin-A (Renova), alpha hydroxyacid lotion and beta hydroxyacid applied daily to areas of sun damaged skin will reverse some microscopic keratoses and help prevent new ones.